CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: M Health Fairview University of Mn Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $139
Cash Discount Price: $343
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at M Health Fairview University of Mn Medical Center is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.30x the Medicare baseline. Located in 2450 Riverside Avenue, Minneapolis, MN.

Cash / Self-Pay

$343

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $343 (321%)

Insurance Median: $139 (130%)

Cash: $343 (321% of Medicare)

Ins. Median: $139 (130% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Health Partners	$32 - $322	30%
Itasca Medical Care	$32 - $127	30%
Primewest	$32 - $127	30%
South Country Health Alliance	$32 - $127	30%
Ucare	$33 - $352	31%
Medica	$35 - $841	33%
Hennepin Health	$36 - $108	34%
Blue Cross Blue Shield	$37 - $488	35%
Sanford Health Plan	$44 - $691	41%
Security Health Plan	$44 - $880	41%
UnitedHealthcare	$44 - $669	41%
Wellcare	$44 - $127	41%
Cigna	$90 - $657	84%
Emerging Therapies	$103 - $751	96%
Humana	$105 - $763	98%
Aetna	$109 - $798	102%
Interlink	$121 - $880	113%
America'S Ppo	$122 - $845	114%
First Health	$132 - $963	124%
Multiplan	$137 - $998	128%
Private Healthcare Systems	$137 - $998	128%
Wisconsin Physician Services	$145 - $1,057	136%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $343.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72131.

Insurance In-Network Protection Plan

Contact your insurance company to confirm M Health Fairview University of Mn Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72131.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.